الفهرس 
Introduction and Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
INTRODUCT’lON AND
AIM OF THE WORK
Involvement of autonomic nervous system (ANS) may occur in patients with RA. Whether this involvement is related to the disease or its treatment is not fully understood .But it is suggested that subclinical involvement of ANS occurs without evident sensory or motor neuropathy (Tollssirot et al.,1993)
The involvement of nervous system in RA is well known, while few studies have been devoted to autonomic neuropathy in RA (Louthrenoo et al., 1999)
Activation of certain neuropeptides like substance p, calcitonin gene related peptide, and other neuropeptides may contribute to the pathophysiology ofRA (Joyce et al., 1993 and Menkes et af., 1993).
There is evidence that the pancreatic polypeptide (PP) level reflects cholinergic tone as secretion of PP is blocked by atropine and decreased by truncal vagotomy in rats (Schwartz, 1983).
Pancreatic polypeptide (PP) may therefore be regarded as a possible marker of autonomic nervous function. Basal PP combined with post prandial PP has been measured in patients with RA (Bekkelund el af., 1996).
Studies on the ANS in RA have been performed by means of tests of cardiovascular reflex function (breathing ratio, val salva ratio, arising systolic BP, and 30/15 ratio) and sweat tests. Autonomic dysfunction was found in 30-50% of the patients (Toussirot et al., 1993) .
The AIM OF THlS WORK is to study cardiovascular autonomic nervous function in patients with RA compared with controls and to investigate fasting and after meal stimulated PP and its possible association with autonomic dysfunction and dise’ase activity.